title: Analysis of risk factors for recurrence of giant cell tumor of the sacrum and mobile spine combined with preoperative embolization.
abstract: OBJECTIVE
  To investigate the factors related to the local recurrence-free survival time (LRFS) after surgical treatment of GCT of the sacrum and mobile spine combined with preoperative embolization.
  
  
  METHODS
  We retrospectively reviewed 28 consecutive patients with GCT of the sacrum and mobile spine who underwent initial surgical excision combined with preoperative embolization between 1995 and 2011. Data regarding age, gender, tumor location, tumor size, tumor extension, radiation therapy, and local recurrences were reviewed and analyzed statistically.
  
  
  RESULTS
  All patients underwent intralesional resection. The average duration of follow-up was 86.4 months (range, 15 - 193 months). 8 (28.6%) patients developed local recurrence. The average recurrence time was 35.6 months (range, 5 - 79 months), and the local recurrence-free survival rates at 3 and 5 years were 89.1% and 75.5%, respectively. LRFS was found statistically longer in intracompartmental (T1) tumors as compared with extracompartmental (T2) tumors (P < 0.05), but not for age, gender, tumor location, tumor size, or radiation therapy.
  
  
  CONCLUSIONS
  Intralesional excision with preoperative embolization is a feasible choice for T1 tumors of the sacrum and mobile spine, but for T2 tumors, more aggressive treatment may be required. The choice of surgical treatment should be balanced between the complications and tumor recurrence.
authors.affiliation: The First Affiliated Hospital of Soochow University, Department of Orthopedic Surgery, Suzhou, Jiangsu, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Ming
authors.forename: Chen
authors.initials: C
authors.lastname: Kangwu
authors.forename: Yang
authors.initials: Y
authors.lastname: Huilin
authors.forename: Wang
authors.initials: W
authors.lastname: Genlin
authors.forename: Lu
authors.initials: L
authors.lastname: Jian
authors.forename: Ji
authors.initials: J
authors.lastname: Yiming
authors.forename: Wu
authors.initials: W
authors.lastname: Chunshen
authors.forename: Chen
authors.initials: C
authors.lastname: Chao
mesh_terms: D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D012447:Sacrum; D013125:Spinal Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult